1.1. Life expectancy and healthy life expectancy at birth
Life expectancy at birth continues to
increase in European countries, reflecting reductions in mortality rates at all ages.
These gains in longevity can be attributed to a number of factors, including rising living
standards, improved lifestyle and better education, as well as greater access to quality
health services. Better nutrition, sanitation and housing also play a role, particularly
in countries with developing economies (OECD, 2011b).
Average life expectancy at birth
for 2008-10 across the 27 member states of the European Union reached 75.3 years for men
and 81.7 years for women (Figure 1.1.1), a rise of 2.7 and 2.3 years
respectively over the decade from 1998-2010. In more than two-thirds of EU member states,
life expectancy exceeded 80 years for women and 75 years for men. France had the highest
life expectancy at birth for women in 2008-10 (85.0 years), and Sweden for men
(79.4 years). Life expectancy was lowest in Bulgaria and Romania for women (77.3 years)
and in Lithuania for men (67.3 years). The gap between EU member states with the highest
and lowest life expectancies is around eight years for women and 12 years for men.
The gender gap in life expectancy at
birth in 2008-10 stood at 6.4 years, around half a year less than a decade earlier.
However, this hides a large range among countries, with the smallest gap in Sweden, the
Netherlands and the United Kingdom, along with Iceland (about four years) and the largest
in Lithuania (over 11 years). The recent narrowing of this gap in most countries can be
attributed at least partly to the narrowing of differences in risk-increasing behaviours
between men and women, such as smoking, accompanied by sharp reductions in mortality rates
from cardiovascular diseases among men.
Looking ahead, Eurostat projects that
life expectancy will continue to increase in the European Union in coming decades, to
reach 84.6 years for males and 89.1 for females in 2060. Convergence among countries is
expected to continue, with the largest increases in life expectancy to take place in those
countries with the lowest life expectancy in 2010 (EC, 2012a).
In a context of increasing life
expectancy and population ageing, healthy life years (HLY) has been endorsed as an
important European policy indicator to address whether years of longer life are lived in
good health (Joint Action: EHLEIS, 2012). The current leading indicator of HLY is a
measure of disability-free life expectancy which indicates how long people can expect to
live without disability. On average for EU member states, HLY at birth in 2008-10 was
62.2 years for women and 61.0 years for men. It was greatest in Malta for women, and in
Sweden for men, and shortest in the Slovak Republic for both men and women (Figure 1.1.1). Women in Malta can expect to live 86% of life expectancy
without limitations in usual activities. For men in Sweden, the value is even higher at
89%. In the Slovak Republic, only 66% of female and 73% of male life expectancy is free
from activity limitation.
The spread of values for HLY at birth
among EU member states are much greater than for life expectancy, being 19 years for women
and 18 years for men. Since the HLY indicator has only recently been developed, there is
as yet no long time series. In contrast to the 6.4 year gap in life expectancy at birth
for EU member states on average, the gender gap in HLY at birth was only around 1.2 years
in 2008-10. For life expectancy at birth the gender gap has always favoured women.
However, seven countries had a gender gap in HLY which favoured men, the greatest
being 2.0 more HLY for men in Portugal. Of the remaining countries, Lithuania had the
largest gender gap in HLY favouring women. The European Innovation Partnership on Active
and Healthy Ageing, part of the Europe 2020 initiative, has set an objective of increasing
the average number of healthy life years by two, by 2020 (EC, 2011b).
A wide range of factors affect life
expectancy and HLY. Higher national income (as measured by GDP per capita) is generally
associated with higher life expectancy at birth and also with HLY, although the
relationship is less pronounced at higher levels of national income (Figure 1.1.2). Similarly, Figure 1.1.3 shows that higher
health spending per capita tends to be associated with higher HLY, although there is much
variation for a given level of health spending, confirming that many other factors play a
role in determining the number of healthy life years.
Definition and comparability
Life expectancy measures how long,
on average, people would live based on a given set of age-specific death rates.
However, the actual age-specific death rates of any particular birth cohort cannot be
known in advance. If age-specific death rates are falling (as has been the case over
the past decades), actual life spans will, on average, be higher than life expectancy
calculated with current death rates.
Healthy life years (HLY) are the
number of years spent free of activity limitation, being equivalent to disability-free
life expectancy. HLY are calculated annually by Eurostat and EHLEIS for each EU
country using the Sullivan (1971) method. The underlying health measure is the Global
Activity Limitation Indicator (GALI), which measures limitation in usual activities,
and comes from the European Union Statistics on Income and Living Conditions (EU-SILC)
Comparing trends in HLY and life
expectancy can show whether extra years of life are healthy years. However, valid
comparisons depend on the underlying health measure being truly comparable. While HLY
is the most comparable indicator to date, there are still problems with translation of
the GALI question, although it does appear to satisfactorily reflect other health and
disability measures (Jagger et al., 2010).
Indicator in PDF
1.1.1 Life expectancy (LE) and healthy life years (HLY) at
birth, by gender, 2008-10 average
1.1.2 Healthy life years (HLY) at birth and GDP per capita,
1.1.3 Healthy life years (HLY) at birth and health spending
per capita, 2008-10 average